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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99100044

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Catherine JessieChisholm Sex Female

Date of Birth August 19, 1923 Place of Birth JudiqueCounty of Inverness

Name of Father William D. Chisholm MAIDEN NAME of Mother Mary MacDonald

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Judique Present address of Father deceased

Occupation of Father at Birth of child Farmer Place of birth of Father Judique

Race Name and present address of Physician in attendance at birth

Signature of Applicant Catherine Jessie Smapson Address of Applicant 55 Ellerslie Cres. Dartmouth Date January 3, 1989

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Catherine JessieChisholm

Born at Judique in the County of Inverness

That Catherine JessieChisholm Whose Birth is sought to be registered was

born at Judique Inverness County on August 19, 1923

My knowledge of the fact and date of such Birth is based on the following Circumstances:

Baptism Marriage Extract

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